Screening for Chronic Kidney Disease in a Rural African American Cohort: a pilot study validating and comparing a novel, non-invasive algorithm for kidney disease Introduction The proposed study will explore the algorithm's, called SCORED, efficacy (sensitivity and specificity) in determining chronic kidney disease (CKD) among rural African Americans. Our approach is innovative in two ways. First, we will target an understudied population at high risk for CKD, rural African Americans in North Carolina (NC). Second, we will assess the effectiveness of the survey instrument in two important ways;(1) validation of SCORED as a gold standard in a community screening effort;and (2) comparison of the algorithm to the current standard, dipstick microalbuminuria in detecting CKD. Rationale CKD is recognized as a health epidemic that affects over 26 million Americans. It disproportionately affects African Americans. Among the fifty states, NC ranks in the top ten for end-stage kidney disease (ESKD) prevalence rates and NC's highest ESKD rates occur in rural counties where African Americans account for over 50% of the population. Targeted, community-based CKD screening holds promise as a tool for early prevention, early intervention and improved awareness among at-risk populations, yet there is a paucity of data comparing innovative, inexpensive and non-invasive screening interventions'with the standard assessment for microalbuminuria and proteinuria. Objective This study seeks to answer two questions. First, what is the efficacy of the SCORED prediction model among a rural African American population? Second, how does the SCORED model's ability to predict CKD compare to that of screening for urine microalbuminuria in a rural, African American population? Methods In two rural NC counties with high rates of advanced kidney disease, and populations with greater than 50% African Americans, we will administer two targeted screening interventions, within the context of an established CKD community-based, outreach and awareness program. By comparing participants'SCORED algorithm generated risk scores as well as their standard screening protocol risk scores with the estimated glomerular filtration rate (based on serum creatinine), we will be able to assess the efficacy of the less expensive and less invasive SCORED algorithm in a rural, African American population. PUBLIC HEALTH RELEVANCE: Screening for Chronic Kidney Disease in a Rural African American Cohort: A Pilot Study Validating and Comparing a Novel, Non-invasive Algorithm for Kidney Disease In the context of an established community-based, CKD prevention and education program, the proposed study will assess the effectiveness of the SCORED, a novel, inexpensive and non- invasive algorithm for kidney disease and compare it to a standard CKD screening intervention that tests for the presence of microalbuminuria for an understudied and under-served population, rural African Americans at high-risk for CKD.